Joseph Devaughn Williams, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

090721 Issued in NY

Practice address

1111 Amsterdam Avenue
New York, 10025 10025

Phone

(718) 810-8021

Fax

(347) 548-4554

NPI assigned

Feb 1, 2021

Last updated

Oct 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Joe Williams LCSW, PLLC

  • Clinical Social Worker
  • Mount Vernon, NY
  • NPI 1942010830
  NPD Authorized official
• Lived Experience Therapists, LCSW PLLC

  • Clinical Social Worker
  • Queens Village, NY
  • NPI 1902763915
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1598356685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16911 144TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11434",
            "telephone_number": "718-810-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVENUE",
            "city": "NEW YORK",
            "state": "10025",
            "postal_code": "10025",
            "telephone_number": "718-810-8021",
            "fax_number": "347-548-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOSEPH",
        "middle_name": "DEVAUGHN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-01",
        "last_updated": "2022-10-28",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.